{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T14:45:03Z","timestamp":1786545903310,"version":"build-2736575974"},"reference-count":57,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T00:00:00Z","timestamp":1559779200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro Eating Disorders Rev"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Therapeutic alliance (TA) is a relevant aspect in anorexia nervosa (AN), but data on inpatients are lacking. We aimed to evaluate the influence of motivation to change, diagnostic subtypes, and duration of illness on TA at hospital discharge; we also investigated if baseline clinical characteristics were associated with discharge TA, and the TA\u2010outcome association.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We enrolled 137 adult inpatients with AN completing Eating Disorder Examination\u2010Questionnaire, Beck Depression Inventory, State\u2013Trait Anxiety Inventory, Anorexia Nervosa Stages of Change\u2010Questionnaire, EuroQoL\u2010Quality of Life Scale\u2010Visual Analogue Scale, and Working Alliance Inventory\u2010Short Revised.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients with different AN subtypes and duration of illness reported similar TA. Baseline depression, state anxiety, and motivation to change were statistically significantly associated with TA at discharge. After controlling for all these variables and duration of illness, only motivation to change remained statistically significant. Statistically significant correlations were also found between improvements in body mass index and quality of life and discharge TA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Few data exist on TA in inpatients with AN and a long duration of illness. Our findings suggest that baseline motivation to change correlates with TA at discharge independently of other variables. Future studies should ascertain as to whether a causal link exists or not.<\/jats:p><\/jats:sec>","DOI":"10.1002\/erv.2687","type":"journal-article","created":{"date-parts":[[2019,6,7]],"date-time":"2019-06-07T02:08:16Z","timestamp":1559873296000},"page":"671-681","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Therapeutic alliance in inpatients with severe anorexia nervosa"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1328-9678","authenticated-orcid":false,"given":"Enrica","family":"Marzola","sequence":"first","affiliation":[{"name":"Eating Disorders Center for Treatment and Research, Department of Neuroscience University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Albini","sequence":"additional","affiliation":[{"name":"Eating Disorders Center for Treatment and Research, Department of Neuroscience University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Delsedime","sequence":"additional","affiliation":[{"name":"Eating Disorders Center for Treatment and Research, Department of Neuroscience University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Secondo","family":"Fassino","sequence":"additional","affiliation":[{"name":"Eating Disorders Center for Treatment and Research, Department of Neuroscience University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5826-5664","authenticated-orcid":false,"given":"Giovanni","family":"Abbate\u2010Daga","sequence":"additional","affiliation":[{"name":"Eating Disorders Center for Treatment and Research, Department of Neuroscience University of Turin  Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000021"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2011.74"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22327"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0272-7358(88)90050-5"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1961.01710120031004"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20931"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0085885"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2012.06.017"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22287"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22177"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40273-018-0642-5"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.73.2.203"},{"key":"e_1_2_8_15_1","first-page":"298","volume-title":"Bergin and Garfield's handbook of psychotherapy and behavior change","author":"Crits\u2010Christoph P.","year":"2013"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20494"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2012.07.002"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.5772\/32699"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8510(90)90421-9"},{"key":"e_1_2_8_20_1","volume-title":"Cognitive behavior therapy and eating disorders","author":"Fairburn C. 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